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Nurses: At the Core of the Patient Care Team

Nurses are at the core of the patient care team. Whether a patient is diagnosed with cancer, admitted to the Swedish Neuroscience Institute or delivering a healthy baby, they receive care from a team of highly-skilled and dedicated nurses.

Many of us take it for granted that our nurses will be skilled, competent and caring. But how do new nursing school graduates learn how to be effective caregivers?

Swedish’s senior nursing leadership created Swedish's innovative Registered Nurse (RN) Residency Program in 2010, after doing extensive research on nationwide best practices for effectively transitioning academically trained RNs with bachelor's degrees to a commitment to careers in the stressful and demanding environments that nurses face in critical care settings.

The goal of the program is to address at Swedish the serious problems posed by a looming national shortage of experienced and skilled hospital critical care nurses. An important strategy for accomplishing this goal lies in reducing the troublingly high percentage of newly hired RNs who drop out of the profession during the first year or two after they are hired.

The inaugural Destination Swedish luncheon event on Feb. 11 generated nearly $500,000 for the program, which has been carefully designed to promote a culture of peer support and shared learning between new RNs who go through an intensive 12- to 24-week residency program together.

The following is an interview with Susan Jones, clinical educator in the program.

What is a nurse residency and why it is important?

Susan: Nursing school teaches the basics—entry level skills and the critical thinking skills necessary to think through clinical scenarios. When the newly licensed nurse works in a hospital setting, the patients deserve and expect excellence at every point in their care. This is a tall order for the new nurse. A nurse residency is a working educational experience where a newly licensed nurse is supported as they transition from the academic environment to the hospital environment.

This support includes one-on-one supervision by an experienced staff nurse for 12 to 24 weeks (depending on the specialty), frequent simulations where the nurse provides care to a high-fidelity mannequin (so practice can occur without placing real patients at risk), specialty specific education, formal performance feedback from the manager and educators, and the support and guidance by a team of advanced practice nurses who specialize in education.

The RN Residency Program at Swedish seems like a significant investment. How is it funded?

Susan: Nurse residency programs and simulation are very expensive ways to learn, but we find the learning so superior, as measured from the patient’s perspective, to be a tremendous asset. The nursing residency program graduates are more self-confident, have better job satisfaction, and stay at Swedish longer than the national averages. Swedish’s new graduate turnover rate is 6.4 percent. The national average is 13 to 24 percent, and can range up to 60 percent.

Gifts from the community have had a significant impact on our ability to develop and expand our nurse residency program. Thanks to the Destination Swedish fundraising luncheon that was hosted on Feb. 11, we have received nearly $500,000 from our generous donors that will help expand this program so even more new nurses—from a broad spectrum of specialties—can benefit from the residency program.

Conflicting stories have emerged over the years about a pending “national nurse shortage.” Is this shortage of quality nurses a reality?

In the Nov. 26, 2008 issue of the Journal of the American Medical Association, workforce analyst Dr. Peter Buerhaus stated: “Over the next 20 years, the average age of the RN will increase and the size of the workforce will plateau as large numbers of RNs retire. Because demand for RNs is expected to increase during this time, a large and prolonged shortage of nurses is expected to hit the US in the latter half of the next decade.”

What is the major difference you see between new nursing graduates who have had the benefit of a residency training program and those who have not?

Susan: All newly licensed RNs at Swedish are enrolled in the RN Residency Program. Many studies have shown that nurses who transition to practice without the support of a program have higher stress levels, poorer patient outcomes, less job satisfaction, and many leave nursing all together!